Went to my RA yesterday (was diagnosed in May). He continues to be amazed that I have doing so well (pain free) with just MTX 12 mg. That all sounds good, but then he told me that I have "aggressive RA". He is from Pakistan and difficult to understand so I don't know what he said had indicated "aggressive". I hate to keep asking him to repeat himself. I am assuming this showed up in the first round of blood work that seemed very extensive.
Does anyone know what part of the blood test would have indicated aggressive RA? It might have been something like CBP or CCP, but maybe it was my RA factor. I got a copy of my most recent blood work so I can begin to better understand all of this.
Thanks
Most, but not all, people with rheumatoid arthritis have the rheumatoid-factor antibody in their blood. (Rheumatoid factors are actually antibodies that bind other antibodies.) Rheumatoid factor may sometimes be present in people who do not have rheumatoid arthritis. Other diseases can also cause the rheumatoid factor to be produced in the blood. Therefore, the diagnosis of rheumatoid arthritis is based on a combination of the joint symptoms and appearance as well as laboratory information and not just the presence of the rheumatoid factor in the blood.
A newer, more specific blood test for rheumatoid arthritis is the citrulline antibody test. When positive, it is very suggestive of rheumatoid arthritis. Citrulline antibody presence also implies a tendency toward a more aggressive form of rheumatoid arthritis.
People with rheumatoid arthritis may have a mild anemia. Blood tests may also reveal an elevated erythrocyte sedimentation rate (ESR) or elevated C-reactive protein (CRP) levels, which are markers of inflammation.
Some people with rheumatoid arthritis may also have a positive antinuclear antibody test (ANA). This test is indicative of the fact that rheumatoid arthritis is an autoimmune disease.
In another major breakthrough, scientists have discovered the importance of a substance called citrulline as a target for immune attack in rheumatoid arthritis (RA). This immune system antibody associated with rheumatoid arthritis recognizes citrulline, which seems to be a key player in the condition. Indeed, the HLA associations with RA have now been shown by Dr. Gregersen and others to directly regulate the immune response to proteins containing citrulline. Citrulline is formed when a specific enzyme comes in contact with arginine, one of 20 common amino acids in proteins. When one of the enzymes is present, nitrogen is removed from the chemical structure of arginine and it converts into citrulline.
Laboratories have developed a test to measure for anti-cyclic citrullinated peptide antibody, or anti-CCP. It is now being used as a diagnostic for rheumatoid arthritis. Scientists are now finding that patients have CCP antibodies months or years prior to the illness, suggesting a way to identify the disease before it starts and perhaps offer treatments to stave off the symptoms. It turns out that those with these antibodies who also have a particular variety of HLA, a complex of genes that regulate immune function, have a 30 times higher risk of developing rheumatoid arthritis than those without these genetic risk factors.
Dont feel bad about having to keep asking your rheumy to repeat himself. It is your body and your disease and if he is telling you something that you don't understand you need to keep asking him until you are satisfied and understand. If he is unwilling to comply, find another. I've gone through quite a few until I found the one that I LOVE!! Its well worth the looking!Hey Roxy,
Glad to see you posting.